Subacute neocortical stimulation (SNCS) and its effects on epileptic activity in adults and children diagnosed with focal cortical dysplasia (FCD)

•Continuously applied subacute neocortical stimulation significantly decreases seizure frequency.•Both de- and increase of epileptiform discharges were associated with reduced seizure frequency during stimulation.•Results suggest both protective- and harmful roles of EDs, depending on the area of or...

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Bibliographic Details
Published in:Epilepsy research 2020-10, Vol.166, p.106392-106392, Article 106392
Main Authors: Freigang, Sascha, Jiménez-Jiménez, Diego, Kazi, Farhana, Díaz-Díaz, Judit, Pina, Marisa, Cunha, Maria, Alarcón, Gonzalo, Selway, Richard P., Valentín, Antonio
Format: Article
Language:English
Subjects:
Cortical stimulation
Epilepsy surgery
Epileptiform discharges
intracranial EEG
Neuromodulation
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Summary:•Continuously applied subacute neocortical stimulation significantly decreases seizure frequency.•Both de- and increase of epileptiform discharges were associated with reduced seizure frequency during stimulation.•Results suggest both protective- and harmful roles of EDs, depending on the area of origin.•To identify epileptogenic zones, subacute neocortical stimulation may be used as diagnostic tool during telemetry. Chronic intracranial electrical stimulation is now widely used as treatment for drug resistant epilepsy. Subacute neocortical stimulation (SNCS) can also be performed during EEG recordings with intracranial electrodes (iEEG), but its diagnostic value remains largely unknown. We assessed the effects of SNCS on the frequency of seizures and epileptiform discharges (EDs) during 290 h of iEEG- from 12 patients (6 adults, 6 children) with epilepsy secondary to focal cortical dysplasia (FCD). In 9/12 patients, SNCS periods showed decreased seizure-frequency (Median -73 %, p = 0.0093). At baseline, incidence of EDs were correlated with seizure-frequency (Spearman r = 0.59). However, this correlation disappeared during SNCS and a significant change in the incidence of EDs was observed. In addition, there was a trend towards greater reduction in seizure-frequency during SNCS in patients who underwent surgery. In summary, SNCS can reduce seizure-frequency and changes ED-frequency. The variability in ED changes may be explained by different effects of SNCS depending on electrode location. The magnitude of seizure reduction during SNCS suggests that this technique could contribute to preoperative assessment in epilepsy surgery.
ISSN:0920-1211
1872-6844
DOI:10.1016/j.eplepsyres.2020.106392